Abstract 20503: Trends in Sepsis and In-Hospital Mortality Among Heart Transplant Patients: A United States National Study
Background: Heart transplant recipients are at increased risk of sepsis owing to long-term immunosuppressive therapy. However, the secular variation of this complication in the United States has not been investigated.
Objective: To examine trends of hospitalizations associated with sepsis and in-hospital mortality among heart transplant recipients using a US national database.
Methods: Using the Nationwide Inpatient Sample databases from 2004 through 2012, we identified 119,899 hospitalizations in transplant recipient patients ≥ 18 years of age using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. Of these, 6,783 admissions (mean patient age 62±13 years; 22.4% women) were associated with a concomitant diagnosis of sepsis, severe sepsis, or septic shock and were analyzed as a separate cohort.
Results: Among all hospital admissions in heart transplant patients, the proportion of those complicated by sepsis increased from 3.32% in 2004 to 7.37% in 2012 (P<0.0005); Figure 1. In-hospital mortality occurred in 15.7% and 1.7% of the heart transplant patients with and without sepsis respectively (P<0.0005). Among patients with sepsis, there was a numerical reduction in unadjusted all-cause inpatient mortality from 24.06% in 2004 to 14.28% on 2012; Figure 1. Deaths in patients with sepsis contributed to 35.53% of the total in-hospital deaths among heart transplant patients during the study period.
Conclusion: In heart transplant patients, hospitalizations with sepsis-related complications increased between 2004 and 2012, while the mortality rate numerically decreased. These hospitalizations represented more than a third of the total in-hospital mortality of these patients. A more aggressive approach to manage sepsis is needed to reduce the overall mortality in heart transplanted patients.
Author Disclosures: S. Yandrapalli: None. D. Gandhiraj: None. V. Vuddanda: None. L. Gollapudi: None. W.S. Aronow: None. A.L. Gass: None. C. Aggarwal: None. W.H. Frishman: None. J.A. Panza: None. G.M. Lanier: None.
- © 2016 by American Heart Association, Inc.